The digital revolution is here...almost

The Substance Misuse sector has been relatively slow to embrace digital. Slower even than the NHS where most of us have been booking hospital appointments online for some years and many of us (not me yet) can book a GP appointment and see our medical records from our phone or tablet.

However, recent research I’ve been doing leads me to believe that UK service providers are putting considerable investment into online development to improve the service user experience of treatment.

The pace of development has been slow for a number of reasons.

Austerity, as usual, casts a long shadow. Providers have been so busy re-designing services to meet reduced budgets that it’s been hard to find the time to examine digital properly. Similarly, over-stretched workers have often been too busy to promote new digital approaches with service users — plus there has been considerable skepticism that digital is just management speak for job losses. Additionally, getting digital right usually means diligent planning, rolling out in stages and listening carefully to user feedback which almost inevitably leads to substantial modifications — a necessarily time-consuming process.

With all those caveats out of the way, we are beginning to see some real progress. A number of providers have created innovation units and appointed digital leads and workers. Websites across the sector are being radically revamped and re-launched on an almost weekly basis. Organisations such as CGL recognise that many of their service users routinely use a range of apps in their daily lives and recommend apps by different providers on their website. There are a number of exciting developments summarised below.

Range of innovations

We are starting to see digital developments at every point of the treatment journey:

Screening and assessment

Most treatment providers now offer online tools for people to self-assess their alcohol or drug use. I recently blogged on Blenheim’s Don’t Bottle it Up tool which is based on the internationally recognised Alcohol Use Disorders Identification Test (AUDIT) which has already been used by almost 200,000 people.

The Global Drug Survey has provided a similar service both online and via apps for some years with its Drinks and Drug Meters which compares users’ drink and/or drug consumption to that of other users.

Engagement

Many services have used low-level tec such as text messages to build engagement with service users. Some organisations use automated systems to remind service users of appointments, others just get in touch manually to see how referral appointments, jobs interviews or court appearances have gone.

An increasing number of services now offer the chance to self-refer via an online form; a real advantage for those at work during normal office hours or who want to capitalise on a moment of motivation on an evening or weekend.

Information and harm reduction

Providers and others are increasingly using online platforms to provide a range of information and harm reduction advice in an easy-to-digest form. This form of advice can be easily and cheaply updated and does not incur the same level of expense as designing and printing posters, information leaflets etc. Examples include the Global Drug Survey whose annual survey originally focused on researching new drug trends but now increasingly puts out harm reduction messages via online advice and TripSit Mobile (an app which collects relevant and easily digestible data on most recreational drugs, including recommended dosages and interactions with other substances, constantly updated as it pulls data from TripSit’s database).

Treatment

Perhaps the best known digital substance misuse treatment programme in the UK is Breaking Free Online. The online programme (which has community, probation and prison versions) is supplemented by an app − see my review here. The app’s main focus is on strengthening peoples recovery and resilience from drug and alcohol difficulties by using mobile technology to bring psychological techniques into real world settings. Because most people have their smartphones with them at all times, the app helps bring the learning from the programme into everyday life and focuses on a range of tools and techniques which will be familiar to those in recovery (and professionals working in the sector):

Access to a mindfulness video created specifically to instantly help manage cravings and urges when they hit.

Access to a mindfulness video developed specifically by psychologists to help manage difficult emotions such as stress and anxiety during times of crisis.

Notifications of high risk places and the essential coping strategies that are personally selected to help overcome potential triggers to relapse.

Notifications to ‘nudge’ or prompt action planning steps that can often slip or be forgotten.

Notifications of positive activities to help with planning your time positively. These alerts are great for helping to get active again, attending appointments and starting to build structure and routine throughout every stage of the recovery journey.

Online recovery

Online support groups are an increasingly important part of recovery for many. Many are organic, established and led by service users on a formal or informal basis. Others, such as SMART Recovery run online facilitated recovery groups five times a week.

The 12-Step recovery movement also uses digital technology. Alcoholics Anonymous and Narcotics Anonymous do not appear to have official apps, but there are a number of popular third party ones; see the screenshot below:

What’s your favourite app?

This post doesn’t seek to be comprehensive in covering the range of online substance misuse tools now available, but I’m very interested in identifying which ones readers think are the most useful. I’d like to write another post looking at a small number of online tools and apps in more detail.